TORONTO — Hospitals should stop charging patients for parking, the Canadian Medical Association Journal said Monday in an editorial that is likely to touch nerves on both sides of the debate.

Written by acting editor Dr. Rajendra Kale, the editorial says parking charges are a health-care user fee in disguise, and an impediment to good care.

Kale, a neurologist at the Ottawa Hospital, said he’s had patients wrap up appointments before the work is completed because they are worried their parking is about to expire.

“I didn’t like that. Because that seemed to be interfering with the clinical process of getting the history, examination, talking to them about side-effects and so on,” he said in an interview from Ottawa.

“They often wait for a long time, as we know, to get appointments…. Having waited for so long, they don’t get the high quality interaction because their mind is on parking.”

Kale, who moved to Canada from the United Kingdom three years ago, noted that health authorities in Wales and Scotland did away with parking fees at hospitals in 2008.
He suggested charging for parking runs counter to the Canada Health Act, which guarantees access to care without financial barriers.

“This is a barrier to health care,” Kale said. “This is anxiety and stress and grief that we can get rid of. That’s my main reason for writing this.”

The suggestion drew an angry response from Tom Closson, CEO of the Ontario Hospital Association, who rhymed off the items the Canada Health Act specifies patients cannot be charged for. Parking was not on the list.

“I think it’s absurd that they would waste space in their magazine for this editorial,” said Closson.

“I think that the Canadian Medical Association Journal should be focusing on things that are a lot more important in health care. I think what they’re focusing on here
is very minor at a time when there are many people in this country that are having trouble getting access to primary care.”

Closson noted that in Ontario, the provincial government only covers about 74 per cent of the cost of running hospitals. The remainder is raised through a variety of revenue-generating schemes — things like rental of space in hospitals for coffee shops, charges for private and semi-private rooms and parking fees.

If hospitals scrapped parking fees they would have to make up the funds some other way or cut services, said Closson, who previously ran several large hospitals, including Toronto’s University Health Network and Sunnybrook Health Sciences Centre.
Or they would have to ask the provincial government for more funds, he said, predicting that wouldn’t fly at a time when the province is already running a deficit.
Closson may think the issue is trivial, but Canadians who have to pay hospital parking fees may not.
The CBC Radio medicine show “White Coat, Black Art” looked at the issue in a recent episode inspired by the parking fees host Dr. Brian Goldman paid when his father was hospitalized for three weeks last summer.
Goldman, an emergency department doctor in Toronto, said he shelled out more than $500 for parking when visiting his father.
Goldman said the show garnered more listener response than any other show in the series, except one on how health care fails women who have trouble breastfeeding.
“It just resonated right across the country,” said Goldman. “Everybody’s got a hospital parking story.”
Goldman acknowledged, though, that not all the people who commented were complaining about the high cost of hospital parking. Some listeners complained that low cost or free parking at hospitals would encourage more people to drive rather than use more environmentally friendly means of getting to hospital, such as public transit.